Organization Active NPI

Refocus Renew Restore LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hagerstown, MD
National Provider Identifier
1710649900
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
REFOCUS RENEW RESTORE LLC
Practice address
201 Prospect Ave Ste 316
Hagerstown, MD 21742-3204
Phone
(240) 614-6170
Fax
(240) 252-7518
NPI assigned
Oct 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Toni MaxwellNPI 1699226258
Title
Owner
Phone
(240) 614-6170

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

201 Prospect Ave Ste 316
Hagerstown, MD 21742-3204

Mailing address

201 Prospect Ave Ste 316
Hagerstown, MD 21742-3204
Phone (240) 614-6170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250415001129 MD Part B Supplier - Clinic/Group Practice 2466977202 Receives reassigned benefits from 1 practitioner
Practice locations: Hagerstown, MD

National Provider Directory

National Provider Directory

Locations

201 Prospect Ave
Ste 316
Hagerstown, MD 21742
Phone (240) 614-6170

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1710649900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PROSPECT AVE STE 316",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217423204",
            "telephone_number": "240-614-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PROSPECT AVE STE 316",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217423204",
            "telephone_number": "240-614-6170",
            "fax_number": "240-252-7518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFOCUS RENEW RESTORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-06",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "TONI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-614-6170"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.